Language

Bulletin of the World Health Organization

Menu

Nigeria leads fight against “killer” counterfeit drugs

Nigeria has been at the forefront of global efforts
to fight counterfeit drugs since Dora Akunyili
took over the National Agency for Food and Drug
Administration and Control (NAFDAC) in 2001. To
crack down on counterfeits, her first move was to
stamp out corruption within her own agency as

In five years Akunyili, a 52-year-old professor
of pharmacology, has attained celebrity status in
Nigeria because of her uncompromising stand
against corruption. “We have been rebuilding
NAFDAC from a moribund government agency to
[one that meets] international standards,” she told
the Bulletin.

Nigeria is ranked as one of the most corrupt
countries in the world, according to Transparency
International. Before Akunyili took over, staff
abused their position to extort money from honest
manufacturers at the same time as taking bribes
from counterfeiters in return for access to the
Nigerian medicines market. Akunyili fired the
most corrupt of her officers. To encourage honesty
among her remaining 3000 staff and to boost
morale, she offered incentives such as training
abroad, improved facilities and a better working
environment.

Akunyili told the Bulletin: “The level of
corruption we had in 2001 cannot in any way be
compared to what we have now. It has decreased
to almost zero. But it is still a problem. We cannot
rule it out completely.”

The Nigerian agency is now a key player
in reducing the manufacture and distribution of
counterfeit medicines in West Africa. It has the
support of the Food and Drug Administration
and the Environmental and Occupational Health
Science Institute at Rutgers University in the
United States of America, among other regional
and international agencies including WHO.

According to Akunyili, drug counterfeiting
was first reported in Nigeria as early as 1968,
“So people have been dying in this country from
the effect of fake drugs since the early 1970s”. In
1995, Nigeria reportedly donated 88 000 doses
of meningitis vaccine to its neighbour Niger, but
before the authorities realized that these vaccines
were fake, about 60 000 people had been
“inoculated”. Akunyili said that when she took
office in 2001, fake drugs were openly circulating
in her country.

Her efforts have led to increased public
awareness about counterfeit drugs and tougher
surveillance at Nigerian customs. She says that
the number of fake drugs in circulation in Nigeria
has been substantially reduced, although she and
everyone else involved in fighting the illegal trade
admit how difficult it is to quantify the problem
and therefore measure their success. Still, there is
plenty of anecdotal evidence that her measures
have had an impact: shopkeepers no longer
dare to sell counterfeits openly for fear of being
reported to the authorities. Criminals behind the
trade have left Nigeria and set up business in
other countries, she says. Now governments across
West Africa are working closely with Nigeria to
crack down on the illegal trade.

How did Akunyili do it? In 2001, most
Nigerian consumers were oblivious to the danger
of counterfeit drugs. “Fake drug dealers used to
thrive mainly because of a lack of awareness”. The
agency broadcast jingles on radio and television
to make the public aware of the dangers and
to encourage people to report suspicious drugs.
It also regularly publishes lists of counterfeit
products in the newspapers. Last year, fake drugs
worth about two billion naira (US$ 16 million)
were voluntarily handed over by counterfeiters or
seized after tip-offs from the public.

Akunyili has hit back at the counterfeiters
directly too. There is tough surveillance at ports
and airports where medicines enter the country.
The authorities inspect shops and markets where
medicines are sold. As of June 2006, Akunyili said
she had secured convictions for 45 counterfeiters
with 56 cases pending. The Nigerian authorities
recently opened a laboratory in Port Harcourt that
analyses medicines for authenticity. Another is
being set up in Calabar.

“Fake drugs were not only killing people
[but] the drugs were also killing businesses. So
millions of lives have been saved. Industries have
been revived,” she said, referring to the damage
counterfeiting does to public trust in companies
and their products.

Despite Nigeria’s efforts, Akunyili said: “We
are not there yet. Even 1% fake drugs is not good
enough, because every life is important.” Akunyili
said she has asked the Nigerian parliament to
amend existing legislation to make penalties
tougher, so far without success. “The penalty for a
fake drug producer or importer ranges from 5000
to10 000 naira (US$ 40–80), or between three
months and five years imprisonment.” The other
problem is that the law is not always enforced
properly: the counterfeiter may avoid jail, and
fines can be insignificant compared with the huge
profits from the illegal trade.

But Akunyili says that the biggest challenge
her agency currently faces is the open-air drug
market in the city of Onitsha in south-eastern
Nigeria. She believes that the bulk of fake drugs
distributed in Nigeria originate there. Police raids
have been unsuccessful because market traders
attacked law enforcement officers. “Our officers
literally had to escape [to avoid] being lynched”.
But Akunyili is determined. “If they defeat us, they
have defeated Nigeria.”